Jeopardy 1- Pulm ID Flashcards
Meningitis Ages and Antibiotic PPX
0-1 Month: GBS, E. coli and Listeria
PPX- Amp + Gent (or Cefotaxime)
1-3 Month: GBS, S. pneumo and Listeria
PPX- Amp + Cefotaxime (+Vanc if meningitis suspected)
3Month-3yrs: S. pneumo, H. flu, Niesseria
PPX- Cefotaxime (+Vanc)
3yrs-Adult: S. pneumo and Niesseria
PPX: Cefotaxime (+Vanc)
Time of Fever of Unknown Origin
8 Days-3 Weeks w/o diagnosis
When is the highest incidence of bacterial meningitis
First month of life
CSF Findings of bacterial meningitis
- Pleocytosis w/ neutrophils
- Hypoglycemia (CSF:Serum is less than 0.4)
- Increased protein
- Gram Stain
Drug that reduce incidence of hearing loss w/ HIB meningitis
Corticosteroids w/ first dose of ABX
CSF Findings of bacteria, virus, TB and Fungal
Bacteria: Neutrophils, High Protein, Low Glucose, Gram
Viral: Lymphocytes (HSV = RBCs), Norm-High Protein, Normal Glucose
TB: Lymphs, Very High Protein, Very Low Glucose, Acid Fast
Fungal: Lymphs, High Protein, Normal Glucose, Negative Cx
Most common complication of meningitis
Hearing Loss
Brain imaging in TB meningitis
Basilar Enhancement
MOST COMMON Viral Meningitis
Enterovirus
Treatment of TB Meningitis
Isoniazid + Rifampin + Pyrazinamide + Streptomycin
MAJORITY of PEDS acute illness visits
URI
Causes of Acute and Subacute Bacterial Sinusitis
S. pneumo, H. flu and M. cat
Antibiotic for bacterial sinusitis
Amoxicillin
Pharyngitis + Enlarged Posterior Cervical Lymph Nodes + Hepatosplenomegaly
EBV
Pharyngitis + painful posterior pharynx vesicles (herpangina)
Coxsackievirus (HFM disease)
Treatment of GBS pharyngitis
Oral or IM Penicillin
Treatment of GBS pharyngitis + penicillin allergy
Erythromycin or Macrolides
Causes of AOM
S. pneumo, H. flu and M. cat
Diagnosis of AOM
Pneumatic Otoscopy to look for middle ear fluid
Treatment of AOM
Amoxicillin +/- Clavulanic Acid
Otitis Externa causes
Pseudo, Staph or Candida
Treatment of mild otitis externa
Acetic Acid solution
Causes of bilateral parotitis
MUMPS + CMV, EBV and HIV
Causes of unilateral parotitis
Staph, S. pneumo and M. tuberculosis
MOST COMMON cause of impetigo
Staph… then GAS
Treatment of impetigo
Topical mupirocin
Path of Erysipelas
Skin infxn of the dermal lymphatics
MOST COMMON cause of Erysipelas
GAS
Buccal cellulitis (blue discoloration of the cheek) suggests
Cellulitis from HIB
Treatment of HIB
Third Generation Cephalosporin
Cause of Perianal cellulitis
GAS
Cause of Staphyloccocal Scalded Skin Syndrome
S. aureus EXFOLIATIVE TOXIN
Rash that begins on trunk –> peripherally w/ erythema and sandpaper like papules
Scarlet Fever
The petichiae of Scarlet Fever are often located within skin creases called
Pastia’s Lines
OCD and tic disorder s/p strep
PANDAS
MOST COMMON cause of gastroenteritis
Rotavirus
Month when you see Rotavirus
Winter
Cause of gastroenteritis in closed populations
Norwalk Virus
MOST COMMON cause of bloody diarrhea 2/2 bacteria
Campylobacter jejuni
Treatment of ETEC and EPEC
Quinolones or Sulfonamides
Treatment of Shigella
Third Gen Cephalosporin or Fluoroquinolones
Treatment of Campy
Erythromycin
Treatment of Yersinia
Third Gen Cephalosporin
Electrolyte finding in diarrhea
Non-Anion Gap HYPERCHLOREMIC METABOLIC ACIDOSIS
Perinatal HIV transmission accounts for
95% peds cases
Transplacental HIV antibody lasts
18-24 months
Vaccine contraindicated in kids w/ HIV
Live Varicella
MOST COMMON HIV opportunistic infection in kids
PCP
Cell affected by EBV
B Cell
Diagnosis of mono in kids under 4`
EBV antibody titers
MOST COMMON complication of Measels
Bacterial PNA
Treatment of Measels
Vitamin A
Measels is caused by
Paramyxoviriridae Family
Rubella is caused by
Togavirus
Congenital Rubella occurs during
1st Trimester
Symptoms of Congenital Rubella
Blueberry Muffin Rash, Thrombocytopenia, HSM, Jaundice, Cataracts, Hearing Loss, PDA
Malaria is transmitted by
Anopheles Mosquito
Diagnosis of Malaria
Giemsa Stained Peripheral Blood
MOST COMMON cause of infectious chorioretinitis
Toxoplasmosis
Cough + Fever + Wheezing + Eosinophils
Loeffler Syndrome (Ascaris Lumbricoides)
Iron Deficiency Anemia
Necator Americanus or Ancylostoma Duodenale
Brain Structure favored by Neurocysticercosis
4th Ventricle
Bronchial tree develops by
16wks
Air Sacs/Pulm Vasculature develops by
26-28 weeks
% Alveoli that develop after birth
90
Age for epiglottitis
2-7
Cause of Epiglottitis
HIB
Thumbprint Sign of X-ray
Epiglottitis
Lab finding in epiglottitis
Leukocytosis w/ Left Shift
Treatment of epiglottitis
IV 2nd-3rd gen Cephalosporin
PPX for epiglottitis
rifampin
Males are 2x more likely to get
Croup and Bronchiolitis
MOST COMMON cause of Croup
Parainfluenza Virus
Steeple Sign on AP Neck X Ray
Croup
Respiratory Distress in Croup is treated w/
Racemic Epi
Stridor + Abrupt Fever and Toxic
Bacterial Tracheitis
MOST COMMON cause of Bacterial Tracheitis
Staph aureus
MOST COMMON lower respiratory disease in 0-2yrs
Bronchiolitis
MOST COMMON cause of bronchiolitis
RSV
Very ill w/ RSV get
Aerosolized Ribavirin
RSV antibody for PPX in premature, heart/lung dz
Palivizumab
PNA causes by AGE
0-3 months: GBS (MOST COMMON), Syphilis, Toxo, CMV, Rubella, HSV and TB
3mo-5yrs: Viruses (Adeno, Influenza A/B, Parainfluenza Virus), S. pneumo, Staph and HIB
>6yrs: M. pneumo and Chlamydia, viruses and S. pneumo (MOST COMMON)
Afebrile Pneumonitis is caused by
Chlamydia
MOST COMMON cause of PNA is
VIRUSES
Viral PNA/Bacterial PNA WBC
WBC > 20,000 NEUTROPHILS is bacterial
WBC < 20,000 LYMPHOCYTES is Viral
Viral vs Bacterial CXR for PNA
Viral- interstitial infiltrate
Bacterial- lobar consolidation
Chlamydia PNA symptoms and TX
NO FEVER, h/o conjunctivitis and staccato-type cough; Eosinophils
Tx- MACROLIDES
Definitive Diagnosis of Mycoplasma PNA is via
Serum IgM Titers for Mycoplasma
Start immunization for Pertussis at
2 months
3 Stages of Pertussis
- Catarrhal Stage
- Paroxysmal Stage
- Convalescent Stage
WBC w/ Pertussis shows
Lymphocytosis
ABX for Pertussis
Azithromycin or Erythromycin
MOST COMMON chronic pediatric disease
Asthma
Percent of Asthma that resolves and ages when it presents
Presents by 1 yr- 50%; 5yrs- 90%
Resolves by puberty- 30-50%
Treatment of Asthma Exacerbations
Albuterol (short acting bronchodilator)
MOST EFFECTIVE anti-inflammatory agents for athhma
Corticosteroids
What decrease vagal tone of the airways in asthma?
Anticholinergic Meds
CF epidemiology
1/2,500 Caucasians
Percent carriers of CF
5%
Chromosome for CF
7
Meconium ileus is present in
20% CF patients
PFTs for CF show
OBSTRUCTIVE pattern
Greatest Risk for aspiration
3mo-5yrs
MOST EFFECTIVE expulsive mechanism for aspirated obj
Nocturnal Cough
Apnea of infancy is
> 20s no breathing
SIDS occurs in
Infants under 1yr
Peak of SIDS
2-4 months
Prevention of SIDS
Sleep on back, Firm bedding, avoid overheating, smoke free, well childs, breastfeeding